Extended early intervention service improves functioning in first-episode psychosis versus standard care

BACKGROUND: This study examined the functional and clinical effects of extending Early Intervention Service (EIS) for individuals with first-episode psychosis (FEP) by one additional year, compared with transitioning to standard care (SC) after completing two years of EIS. Age and duration of untreated psychosis (DUP) were explored as potential moderators across a broad age range (15-55 years). METHODS: Secondary analyses were conducted on two randomised controlled trials involving 400 FEP patients who had completed two years of EIS (extended EIS: n = 202; SC: n = 198). Participants were assessed at two years and again at three years. Multiple linear regression and mixed-effects models were used to evaluate treatment effects and the moderating roles of age (<25 vs ≥25 years) and DUP (<92 vs. ≥92 days). RESULTS: Extended EIS improved functioning relative to SC, including higher employment rates (p = 0.024), increased Role Functioning Scale (RFS) total and subdomain scores (p < 0.001 to 0.015), and better Social and Occupational Functioning Assessment Scale (SOFAS) scores (p < 0.001). Short DUP was associated with greater gains in certain RFS subdomains (p = 0.003 to 0.008) and SOFAS (p < 0.001). Younger patients showed greater improvements in RFS independent living and self-care (p = 0.019), and reductions in overall symptom severity (p = 0.014) and general psychopathology (p = 0.020). CONCLUSIONS: A one-year extension of EIS produced additional functional benefits, with stronger effects observed among younger patients and those with shorter DUP. Extending EIS for individuals who continue to demonstrate functional or clinical difficulties after the initial two-year programme may help optimise long-term recovery and guide efficient service planning.